Yazmin Acosta

• Conduct telephonic investigations by contacting injured employees, supervisors, and medical providers to secure statements or recorded statements depending on the type or severity of the claim.

• Obtain documentation in a timely manner to determine coverage, compensability, and extent of injury.

• Manage various complexity claims for first responders and municipalities, various complexity injuries, and litigated claims.

• Establish and update reserves as more information is received. Issue timely payments of medical bills and indemnity payments to claimants. Manage different daily diaries to stay on top of each claim.

• Conduct telephonic investigations by contacting all parties and obtain
documentation in a timely manner to determine coverage, compensability,
and extent of injury.
• Establish and update reserves to reflect claim exposure and document
rationale. Pursue all offset opportunities, including second injury fund and
subrogation.
• Manage files of various complexities with an emphasis on file quality.
Proactively manage inventory with documented plans of action to ensure
timely and appropriate file closing.
• Achieve optimal end result by returning the injured party to work and
coordinating the appropriate medical treatment in collaboration with
internal business partners.
• Collaborate with the legal team and proactively manage litigation to drive
files to an optimal outcome, including resolution of benefits.
• Apprise all parties of claim status in both verbal and written form
including preparing necessary letters and state filings.
• Mentor peers on highly complex claims and processes.

• Provided excellent customer service throughout the claims process to all parties involved while investigating claims thoroughly to determine liability for damage property.

• Manage car rentals, request auto or damage property appraisals, review reviewed appraisals.
• Explain coverage to insured and payments being issued.
• Calculated reserves to ensure timely payments were made to all parties.

• Resolved service-related complaints and process complex customer calls from frustrated callers and difficult billing scenarios.
• Expert technical support advisor for agency portal website.

• Processed insured requested personal lines policy changes and cancellations.

• Reviewed reinstatement requests, answered underwriting questions from insured and agents.
• Handled special projects as delegated by management.

• Review personal lines customer service calls to assure customer experience expectations and procedures were followed.

• Implemented quality assurance strategies in collaboration with the entirety of the department to accomplish mutual goals.
• Assessed data to produce performance and trends reports for management in a timely manner.

• Managed inbound calls from customers and agents specialized in resolving their inquiries, including, but not limited to: policy, billing, underwriting guidelines, quotes, coverages, and technical support.
• Accomplished customer loyalty through courteous and efficient resolutions of disputes, complaints and discrepancies.